Provider Demographics
NPI:1427710201
Name:GRECO, KRISTINA M (LCSW)
Entity type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:M
Last Name:GRECO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:REGISTERED AGENTS INC
Mailing Address - Street 2:971 US HIGHWAY 202N STE R
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876
Mailing Address - Country:US
Mailing Address - Phone:856-283-0186
Mailing Address - Fax:
Practice Address - Street 1:452 N BROADWAY APT 2
Practice Address - Street 2:
Practice Address - City:GLOUCESTER CITY
Practice Address - State:NJ
Practice Address - Zip Code:08030-1020
Practice Address - Country:US
Practice Address - Phone:908-553-4193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-09
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0262201041C0700X
NJ44SC06452000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical